scholarly journals Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

2010 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Gregory Telman ◽  
Orit Mesica ◽  
Efim Kouperberg ◽  
Oved Cohen ◽  
Gil Bolotin ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Interatrial Septum ◽  
Acute Onset ◽  
Atrial Myxoma ◽  
Clonic Seizures ◽  
The Right ◽  
The Brain ◽  
Trans Cranial Doppler

This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side. Trans-cranial doppler (TCD) microemboli monitoring did not reveal MES. Transesophagial echocardiography (TEE) identified a 5 cm left atrial mass, which was highly suspected to be an atrial myxoma attached to the interatrial septum and prolapsed through the mitral valve. After the TEE results were obtained, another TCD monitoring was performed. Again, there were no MES found in either of the MCAs. Our findings showed the absence of MES on two consecutive TCD examinations, suggesting a spontaneous occurrence, rather than the permanent presence, of embolization, even in the most acute phase of stroke. Thus, the tendency of myxomas to spontaneously produce multiple emboli emphasizes the need for the surgical excision of myxomas.

Atypical Left Ventricular Myxoma: Unusual Echocardiographic and Histopathological Features

2018 ◽  
Vol 11 (4) ◽  
pp. NP129-NP131
Author(s):  
Sushil Azad ◽  
Nilanjan Dutta ◽  
Kuntal Roy Chowdhuri ◽  
Tarun Raina Ramman ◽  
Nishit Chandra ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Histopathological Examination ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Interatrial Septum ◽  
Left Ventricular ◽  
Cardiac Tumors ◽  
Complete Surgical Excision ◽  
Vascular Proliferation ◽  
Cardiac Myxomas

Cardiac myxomas are the most common primary cardiac tumors and are typically attached to the interatrial septum. Left ventricular myxomas are exceedingly rare and presentation in children is all the more uncommon. We report a case of left ventricular myxoma with very atypical cystic appearance raising an initial suspicion of a hydatid cyst. Subsequently, cardiac magnetic resonance imaging was done, which ruled out the diagnosis of hydatid cyst. Complete surgical excision was done through transaortic and transmitral route. Histopathological examination revealed it to be a cardiac myxoma with vascular proliferation, which on echocardiography had appeared as a polycystic lesion. This is a very unusual histopathological presentation of cardiac myxoma.

scholarly journals P853 Bilateral lower limb ischemia in a healthy young man what if the heart was hiding the etiology

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Mouadili ◽  
A Tamdy ◽  
B El Fatmi ◽  
S Elkarimi
Keyword(s):  
Popliteal Artery ◽  
Lower Limb ◽  
Cardiac Myxoma ◽  
Clinical Manifestations ◽  
Limb Ischemia ◽  
Atrial Myxoma ◽  
Surgical Removal ◽  
Left Atrial Myxoma ◽  
Tibial Arteries ◽  
The Right

Abstract Cardiac myxoma is the most common benign cardiac tumor with diverse nonspecific clinical manifestations; moreover, atrial myxoma embolization to the peripheral vessels is rare. A 24-year-old man presented tothe emergency departement complaining ofpain and coldness of his two lower extremities. The right femoral pulse was normally felt while the pulses of the left lower limb from the femoral down to the posterior and anterior tibial arteries were not felt. Bilateral thrombectomy was performed on emergency basisand a fatty-like mass from the left femoral artery was removed. The histological examination of this mass was suggestive of myxoma.So, transthoracic echocardiography was done and confirmed the diagnosis of myxoma that was seen in the left atrium and measuring about 10X6 cm in its maximal dimensions. Surgical removal of the myxoma was done later and the patient recovered uneventfully. Conclusion Although myxomas are rare, they should be considered in the differential diagnosis of peripheral embolic disease, especially when an embolic event occurs in a young adult without evidence of endocarditis or arrhythmia. Echocardiography is the modality of choice for diagnosis and follow-up of this type of tumors. FIGURE 1: CTA (computed tomography angiography) showing Occlusion of the left popliteal artery and occlusion of the distal part of the right popliteal artery FIGURE 2: macroscopic view of gelatinous left atrial myxoma

scholarly journals Wallerian-Like Degeneration After Ischemic Stroke Revealed by Diffusion - Weighted Imaging

2007 ◽  
Vol 34 (2) ◽  
pp. 243-244 ◽  
Author(s):  
P. N. Sylaja ◽  
M. Goyal ◽  
T. Watson ◽  
M. D. Hill
Keyword(s):  
Cerebral Artery ◽  
Diffusion Weighted Imaging ◽  
Acute Onset ◽  
Cerebral Peduncle ◽  
Diffusion Weighted ◽  
Intravenous Tissue Plasminogen Activator ◽  
Hyperintense Signal ◽  
Apparent Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

A 22-year-old female was seen in the emergency within one hour of acute onset of right sided headache followed by weakness of the left side of body. On neurological examination, she was mildly drowsy, had forced right gaze deviation, dysarthria, left hemiplegia and left hemisensory loss. Computed tomography (CT) scan revealed early ischemic changes in the right middle cerebral artery (MCA) territory. The CT angiography done showed evidence of dissection of the supraclinoid segment of the right internal carotid artery with reduced flow distally into the MCA, which was confirmed by a conventional angiogram. In view of the intracranial carotid dissection, the patient was not treated with intravenous tissue plasminogen activator. Magnetic resonance imaging (MRI) of the brain done on the next day revealed evidence of acute ischemic lesions in the right MCA and anterior cerebral artery territory on diffusion-weighted imaging (DWI), with normal brainstem. [Figure 1] A repeat MRI performed 13 days after ictus showed hyperintense signal on DWI in the right cerebral peduncle which was hypointense on apparent diffusion coefficient (ADC) map suggestive of Wallerian-like degeneration. [Figure 2] The signal changes were less conspicuous on T2-weighted images. She had antigravity strength in the left leg but remained weak in her left arm at one month.

scholarly journals Cardiac phoenix in the brain-occult intracranial hemorrhagic metastases from completely resected atrial myxoma

2020 ◽  
Vol 11 ◽  
pp. 383
Author(s):  
Sagar Amrutlal Ghodasara ◽  
Rohit Balasubramanian ◽  
Shriram Varadharajan ◽  
P. S. Shobhanaa
Keyword(s):  
Cerebral Cortex ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Atrial Myxoma ◽  
Gross Total Resection ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Early Recovery ◽  
Total Resection ◽  
Tumor Embolization

Background: Cardiac myxomas are sporadic in nature and can often recur with a frequency of 3%, especially in middle-aged women, and 22% of the cases account to a part of Carney complex. Complete surgical removal of the myxoma is usually curative. Recurrence has been related with partial surgical excision, multicentricity, and embolism of tumor fragments. Case Description: We report a case of a patient with single brain metastases due to tumor embolization, from a cardiac myxoma operated prior. This case is exclusive, as tumor embolization from atrial myxoma to the cerebral cortex can be possible, within a short duration. In our case, the patient was evaluated with a magnetic resonance imaging brain and a solitary hemorrhagic lesion in the eloquent cerebral cortex was observed. To determine the primary etiology, the diagnosis of probable metastases was thought of, and a thorough workup was planned. Surprisingly, no primary lesion was detected, and as a histological diagnosis was required, he underwent a navigation-guided excisional biopsy of lesion. The biopsy was indicative of a metastatic deposit from an atrial myxoma. Conclusion: In eloquent cortex lesions, gross total resection is challenging for a neurosurgeon especially when the patient has no significant neurological deficits. Timely gross total resection of a solitary metastatic lesion can improve the patient’s outcome and can enhance early recovery with less or no morbidity.

scholarly journals Clinical and imaging features of suspected pituitary apoplexy in a domestic rat

2020 ◽  
Vol 8 (2) ◽  
pp. e001062
Author(s):  
Stephen James Everest ◽  
Tobias Schwarz ◽  
David Walker ◽  
Kevin Eatwell ◽  
Katia Marioni-Henry
Keyword(s):  
Pituitary Apoplexy ◽  
Acute Onset ◽  
Postmortem Examination ◽  
Female Rat ◽  
Imaging Features ◽  
Gradient Echo ◽  
History Of ◽  
The Right ◽  
The Brain

A two-year-ten-month-old entire female fancy rat was evaluated for acute-onset neurological signs following a two-month history of lethargy and behavioural changes. Physical examination revealed generalised muscle atrophy. Neurological examination localised the lesion likely to the right thalamus based on suspected left unilateral hemineglect. The patient was euthanased over quality-of-life concerns, and postmortem MRI of the brain was performed, followed by postmortem examination. This showed a lesion in the region of the pituitary which was T1 hyperintense to the brain, T2 isointense to the white matter and hypointense on gradient echo sequences, suggesting subacute haemorrhage. The authors described the clinical presentation and imaging features (MRI) of suspected pituitary apoplexia secondary to a pituitary macroadenoma in an aged female rat. Of particular interest are the findings of unilateral hemineglect and blooming artefact on MRI gradient echo sequences that lead to suspicion of pituitary apoplexia confirmed on postmortem examination.

scholarly journals Vascularization of the Alouatta belzebul brain base

2020 ◽  
Vol 40 (4) ◽  
pp. 315-323
Author(s):  
Dayane Kelly Sabec-Pereira ◽  
Fabiano C. Lima ◽  
Fabiano R. Melo ◽  
Fabiana Cristina S.A. Melo ◽  
Kleber Fernando Pereira ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Terminal Branch ◽  
Vertebral Arteries ◽  
Caudal Portion ◽  
Cerebellar Artery ◽  
The Right ◽  
The Brain ◽  
Left Middle

ABSTRACT: We studied the arterial circle in the brain of five specimens of the Alouatta belzebul primate. The material had the arterial system perfused (water at 40°C), injected with stained latex (Neoprene 650), fixed in aqueous formaldehyde solution (10%) and dissected for vessel verification. The arterial circle of this primate is composed of two vascular systems: the vertebra-basilar and the carotid ones, which anastomose to close the arterial circuit. In the caudal portion of the arterial circle, there are the vertebral arteries and their branches: the rostral spinal artery and the caudal inferior cerebellar artery. The anastomosis of the vertebral arteries gives rise to the basilar artery. It presented an anatomical variation at the beginning of its path, forming a double basilar artery, called arterial island. In its course, it emitted branches giving rise to the rostral inferior cerebellar artery, the pontine arteries, the rostral cerebellar arteries, the satellite rostral cerebellar arteries and its terminal branch, the caudal cerebral artery, which presented itself in two segments: the pre-communicating one and post-communicating, joining the internal carotid artery and originating the caudal communicating artery. This group of arteries and anastomoses enclose the caudal portion of the arterial circle. From the right and left internal carotid arteries begins the rostral portion of the arterial circle, which consists of the right and left rostral cerebral arteries and the right and left middle cerebral arteries. The rostral cerebral arteries anastomose into a single trunk, giving rise to the interhemispheric artery, and in A. belzebul and Sapajus libidinosus, the rostral communicating artery is absent. The interhemispheric artery goes to the midbrain region and the corpus callosum knee divides into pericalous artery and callosarginal artery, which will supply the pre and post-central regions of the cerebral hemispheres of this species, as well as other non-human and human primates. It is noted that in the first part of the left rostral cerebral artery, there is a direct inosculation between the recurrent branch of the rostral cerebral artery and left middle cerebral artery to supply the entorhinal region. This fact also occurs in Pongo spp. The middle cerebral artery travels along the lateral sulcus where it emits several superficial branches to irrigate the superior and inferior lateral cortical regions of the frontal, parietal and temporal lobes. It is not part of the arterial circle but is the terminal branch of the internal carotid artery. A. belzebul can be considered to depend on two sources of supply to the brain: the vertebra-basilar and carotid systems, contributing to the intervention of veterinarians during clinical and surgical procedures in other primates, as well as the preservation of wild animals.

scholarly journals Certain Forms of Matrix Metalloproteinase-9 Accumulate in the Extracellular Space after Microdialysis Probe Implantation and Middle Cerebral Artery Occlusion/Reperfusion

2002 ◽  
Vol 22 (8) ◽  
pp. 918-925 ◽  
Author(s):  
Anna M. Planas ◽  
Carles Justicia ◽  
Sònia Solé ◽  
Bibiana Friguls ◽  
Álvaro Cervera ◽  
...  
Keyword(s):  
Western Blot ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Blot Analysis ◽  
Extracellular Space ◽  
Western Blot Analysis ◽  
Extracellular Fluid ◽  
Microdialysis Probe ◽  
The Right ◽  
The Brain

Matrix metalloproteinases (MMPs) are activated in focal cerebral ischemia. The activation of MMP-9 is involved in blood—brain barrier breakdown and tissue remodeling. The MMPs are released to the extracellular space, but the form and fate of secreted enzymes in brain are unknown. Using microdialysis in vivo, the authors studied whether ischemia-induced MMP-9 in brain tissue was related to free MMP-9 in the extracellular fluid. A microdialysis probe was placed into the right striatum and microdialysis was initiated 24 hours later in controls (n = 7). One hour prior to microdialysis, a group of rats (n = 7) was subjected to 1-hour occlusion of the right middle cerebral artery, followed by reperfusion. Dialysates were collected at discrete time points up to 24 hours, and subjected to zymography and Western blot analysis. The MMP-9 was released after ischemia and accumulated in the extracellular space at 24 hours ( P < 0.05). Free MMP-9 forms include mainly the 95-kd proform, and, to a lesser extent, dimers and cleaved active forms (70 kd), but not the 88-kd form found in tissue. Probe implantation and microdialysis increased free MMP-9 in the dialysate. This increase was concomitant with neutrophil infiltration after the mechanical lesion, as myeloperoxidase was found by means of Western blot analysis in the brain hemisphere subjected to microdialysis ( P < 0.005), and immunohistochemistry revealed the presence of myeloperoxidase stain surrounding the site of probe implantation. The results suggest that certain forms of MMP-9 are released and accumulate in the extracellular space after brain injury, and that vascular alterations and neutrophil recruitment elicit MMP-9 activation in the brain after focal ischemia and trauma.

scholarly journals A systematic study of the brain base arteries in the turkey (Meleagris gallopavo)

2011 ◽  
Vol 31 (suppl 1) ◽  
pp. 39-46 ◽  
Author(s):  
Amarílis Díaz de Carvalho ◽  
Rui Campos
Keyword(s):  
Carotid Artery ◽  
Cerebral Artery ◽  
Systematic Study ◽  
Meleagris Gallopavo ◽  
Collateral Branch ◽  
Cerebellar Artery ◽  
Ethmoidal Artery ◽  
The Right ◽  
The Brain ◽  
Artery Branch

Thirty heads with neck segments of turkeys (Meleagris gallopavo) were dissected for a systematic study of the arteries. The frequency of the arteries found was: Cerebral carotid artery, intercarotid anastomosis and internal ophthalmic artery (100%). Caudal branch of the cerebral carotid artery to the right (R) vestigial artery (70%) and developed (30%) and to the left (L) developed (70%) and vestigial artery (30%). Ventral tectal mesencephalic artery in (70%) to R and (30%) to L was the direct branch of the cerebral carotid artery to L (70%) and to R (30%) collateral branch of the developed caudal branch. Basilar artery to L in (70%) and to R (30%) formed from the developed caudal branch; rostral ventral cerebellar artery present (86.7%) and absent (13.3%) to R and L. Caudal ventral cerebellar artery to R single (73.3%), double (23.3%) and triple (3.3%); caudal ventral cerebellar artery to L single (73.3%) and double (26.7%). Dorsal spinal artery branch of caudal ventral cerebellar artery to R (80%) and to L (73.3%). The rostral branch of cerebral carotid artery showed as collateral branches the single caudal cerebral artery to R (100%) and to L (96.7%) while in (3.3%) it was double. The middle cerebral artery was single to R and L (100%). Cerebroethmoidal artery to R and L (100%) with its collateral branch to single rostral cerebral artery (90%) to R and (86.7%) to L and double (10%) to R and (13.3%) to L. Ethmoidal artery to R and to L (100%) single. The cerebral arterial circle was rostrally and caudally opened, so that the cerebral blood supply was exclusively made by the carotid system.

scholarly journals Multiple cerebral metastases and metastatic aneurysms in patients with left atrial Myxoma: a case report

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Wan ◽  
Hai Du ◽  
Lei Zhang ◽  
Shuang Guo ◽  
Li Xu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Brain Metastases ◽  
Cardiac Myxoma ◽  
Cerebral Aneurysms ◽  
Surgical Excision ◽  
Atrial Myxoma ◽  
Surgical Removal ◽  
Left Atrial Myxoma ◽  
Complete Surgical Excision

Abstract Background Cardiac myxoma is the most common benign cardiac tumor. Brain metastases or multiple cerebral aneurysms are extremely rare, especially for the case of both complications. Brain metastases are usually found at the same time or few months after the diagnosis or surgical removal of cardiac myxoma Case presentation We describe a case of patient, operated for a cardiac myxoma, who presented multiple central nervous system metastases associated, cerebral aneurysms and subsequent intracerebral hemorrhage Conclusions The long-term follow-up of the patients with atrial myxoma even after complete surgical excision is recommended, especially for the patient with central nervous system manifestations before atrial myxoma excision

scholarly journals Simultaneously Performed, Totally Endoscopic Left Atrial Myxoma Resection and Lobectomy

2020 ◽  
Vol 23 (3) ◽  
pp. E292-E294
Author(s):  
Jin Shi ◽  
Yong Wang ◽  
Qiuyun Wang ◽  
Xiaohan Bing ◽  
Zengshan Ma
Keyword(s):  
Cardiopulmonary Bypass ◽  
Cardiac Tumor ◽  
Left Atrial ◽  
Cardiac Myxoma ◽  
Atrial Myxoma ◽  
Robotic Assistance ◽  
Left Atrial Myxoma ◽  
Simultaneous Surgery ◽  
The Right ◽  
Preoperative Examination

The patient was a 69-year-old male patient with cancer in the right lung and whose preoperative examination showed left atrial myxoma. Simultaneous surgery for both cardiac myxoma resection and a lobectomy by totally endoscopic surgery without robotic assistance was performed. First, the cardiac tumor on the heart was removed using a cardiopulmonary bypass (CPB), then a lobectomy without any new incisions was performed. This case provides evidence that in individual select patients, a left atrial myxoma resection and lobectomy can be performed under total endoscopy at the same time.

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